Liver transplantation with renoportal anastomosis after distal splenorenal shunt.

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Abstract
ALTHOUGH endoscopic therapy and the transjugular intrahepatic portosystemic shunt have superseded the role of surgery in the management of portal hypertension, surgical shunt procedures are still a desirable option for selected patients.1,2 Compared with other nonselective surgical shunt procedures, the distal splenorenal shunt (DSRS) is widely used because it offers a low incidence of hepatic encephalopathy and hepatic decompensation.3-5 Despite successful portal decompression by DSRS, some patients may require subsequent orthotopic liver transplantation (OLT) when their liver disease progresses to hepatic failure.